Aspirin Resistance in Patients with Ischemic Stroke

Objective: Aspirin is the basic agent of antithrombotic treatment in ischemic cerebrovascular disease (CVD). Patients who do not respond to the treatment are described as aspirin-resistant. Recent studies have reported an incidence of aspirin resistance among CVD patients of between 3% and 85%. The aim of this study was to determine the frequency of aspirin resistance in CVD patients and evaluate any relationship with demographic characteristics, risk factors, or stroke subtypes. Methods: A total of 163 (106 male, 57 female) acute ischemic stroke patients from a 6-month period treated with aspirin (100 mg, 300 mg daily) were evaluated. Aspirin resistance was measured using a Multiplate platelet analyzer (Roche Diagnostics, Risch-Rotkreuz, Switzerland). Potential correlations between aspirin resistance and stroke subtypes, age, sex, weight, height, hypertension, diabetes mellitus, history of CVD, tobacco use, alcohol use, hyperlipidemia, and fasting blood glucose level were analyzed. Results: Aspirin resistance was determined in 16 male patients and 9 female patients in the group: a total of 25 (15.3%) of 163 patients. There was no statistically significant relationship between aspirin resistance and stroke-related clinical and laboratory parameters. Conclusion: Additional, large, prospective, randomized studies are needed to clarify which patients with ischemic stroke should be tested and how to treat patients with resistance.

İskemik İnme Hastalarında Aspirin Direnci

Amaç: Aspirin, iskemik serebrovasküler hastalıklarda (SVH) antitrombosit tedavinin temelini oluşturur. Bazı hastalarda aspirin tedavisine yeterli yanıt alınamaz, bu durum son zamanlarda aspirin direnci kavramının doğmasına neden olmuştur. Çalışmalarda SVH’da aspirin direnci sıklığı %3–85 oranında değişmektedir. Bu çalışmada, iskemik SVH tanısıyla takip edilen aspirin tedavisi altındaki hastalarda aspirin direnci sıklığı, demografik özellikleri, risk faktörleri, inme alt gruplarıyla ilişkisini araştırmak amaçlandı. Gereç ve Yöntem: İskemik SVH tanısıyla altı aylık sürede izlenen, düzenli aspirin 100–300 mg/gün tedavisi almış ve Multiplate platelet fonksiyon analizatörüyle aspirin direncine bakılmış 163 hasta (106 erkek, 57 kadın) değerlendirilmiştir. Bu hastalarda inme alt tipleri, yaş, cinsiyet, boy, kilo, hipertansiyon (HT), diyabetes mellitus (DM), geçirilmiş SVH, hiperlipidemi (HL), sigara ve alkol kullanımı, açlık kan şekeri düzeyi gibi durumlarla aspirin direnci ilişkisi gözden geçirilmiştir. Bulgular: İskemik SVH tanılı 163 hastanın 25’inde (16 erkek, 9 kadın) aspirin direnci saptandı (%15.3). Aspirin direnci ve inme ile ilişkili klinik ve laboratuvar parametreleri arasında istatistiksel anlamlı herhangi bir ilişki bulunmadı. Sonuç: İskemik inme geçiren hastalardan hangilerine test uygulanması gerektiğinin ve direnç saptanan hastalarda tedavide nasıl bir yol izleneceğinin netliğe kavuşması için daha fazla sayıda ileriye yönelik, randomize çalışmaların yapılmasına ihtiyaç vardır.

Kaynakça

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Kaynak Göster

Southern Clinics of Istanbul Eurasia
  • ISSN: 2587-0998
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2017

1b367

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